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If you have ever had pain in your lower back, know that you are not alone. Thousands of South Carolinians see doctors for this kind of pain each year. And nationally, 1 in 4 working adults experience lower back pain, according to the National Institute for Occupational Safety and Health*. 

That is why it is important to know what kind of care to seek when you experience lower back pain. 

There are two kinds of lower back pain — acute and chronic. The majority of cases are acute pain, meaning a sudden onset possibly related to a specific event. Chronic pain is continual and lasts for a longer period of time. 

How Can I Treat the Pain? 

Many medical professionals recommend treating acute lower back pain at home first. Applying heat or ice, stretching gently and walking are known to help. 

Some people can get pain relief from over-the-counter, anti-inflammatory medicines like ibuprofen (Advil, Motrin IB or generic) or naproxen (Aleve and generic). Be sure to follow the dosages on the package. 

Other recommendations for treating lower back pain can be found here*.

Visit Your Doctor

If self-care does not help, start by visiting a primary care physician. You can find a network doctor on My Health Toolkit®

“We would recommend that you do not necessarily need to go to the ER or a specialist to start off with,” says Dr. Lloyd Kapp, a medical director with BlueChoice HealthPlan. “Your primary care doctor can handle this and assess if further evaluation is needed.” 

Your Medical History Is Important

A primary care doctor will likely conduct a physical exam and ask for a complete medical history. The doctor will check reflexes, strengths and weaknesses to help determine the cause of the pain. It is important to provide a full and complete medical history, according to Kapp. 

“Most of the information a doctor needs to determine treatment for acute back pain can be learned from a thorough medical history and physical examination,” Kapp says.

Imaging Tests May Not Be Necessary

Our most current available data (from 2017) tells us that more than 100,000 unnecessary imaging tests were ordered in an outpatient setting for back pain. More than 14,000 unnecessary tests were ordered in the ER. These tests did not inform treatment and exposed people to potential risks. 

This is why imaging tests such as X-rays, CT scans and MRIs are not recommended for acute back pain within the first six weeks, according to Choosing Wisely, an initiative of the American Board of Internal Medicine (ABIM) Foundation**.

Imaging tests for lower back pain usually do not help and can sometimes cause harm. X-rays and CT scans use radiation. Over time, radiation can be harmful. It is best to avoid radiation when possible. 

Tests Can Be Expensive

These tests can also result in incidental findings and more testing that isn’t necessarily needed. 

Those tests and procedures can come with high costs. Imaging tests can cost hundreds or thousands of dollars. If those tests lead to surgery, the cost could get higher. 

When Are Imaging Tests Needed?

If there are certain red flags, imaging may be necessary, Kapp says. The doctor will assess for those red flags, such as numbness or weakness in the legs. 

Imaging tests may be needed right away. If you have other symptoms, discuss them with your doctor. Other symptoms to look out for: 

  • Weight loss that you cannot explain
  • Fever over 102 degrees
  • Loss of control of your bowel or bladder
  • Loss of feeling or strength in your legs
  • Problems with your reflexes
  • A history of cancer

Know What to Ask 

Before going to see a doctor, know what questions to ask. Choosing Wisely can be a helpful resource for knowing what to ask. 

If the doctor recommends imaging tests before six weeks, ask why.

Other questions to consider asking: 

  • What are you looking for? 
  • What will you do with that information? 
  • How will the results be used to change the treatment? 
  • What happens if I don’t do anything? 
  • How much does it cost, and will my insurance cover it? 

For more information about what to ask your doctor, visit Choosing Wisely*. 

*This article contains links to third party sites. Those organization are solely responsible for the contents and privacy policies on their sites.


**The ABIM Foundation is an independent organization that offers health information that you may find helpful.
 

Nov. 14, 2019

Doctors examine X-rays Hover image

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